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<p>How do you get mom and baby over to the bed after a water birth?  Assume birth was normal and mom and baby have had some time to bond.  Do you:</p>
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<p>1. Cut cord, give baby to dad or someone else handy, help mom to bed, give baby back</p>
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<p>2. Have mom stand up, get out of tub, and walk over to bed while carrying her baby</p>
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<p>or other?  </p>
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<p>Please share your protocol, exceptions, experiences.  Also, does this change if there is significant blood in the water or there are other factors?  </p>
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<p>Thank you!</p>
 

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<p>The midwife I work with prefers her clients to come out of the tub before the placenta comes, which usually means mom is moving about 10-15 minutes after the actual birth.  So usually mom stand up, holds the baby, and we all help get them to wherever she wants to be.  She NEVER cuts the cord before the placenta is out, so that is not a consideration.  If mom feels like she can't hold the baby well while she's getting out of the water, someone else will either help support the baby in her arms or briefly hold the baby until she is settled, but obviously right next to her, since the cord is still intact.</p>
 

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<p>I don't cut the cord until the placenta has come. So, if the placenta has come while in the water, then it makes it easier and dad can take the baby over to the bed while I help the mom step out of the pool and shuffle to the bed. If not, then I had the partner come and be available to help support the baby and the woman while I also do the same and we work as a team to shuffle this woman to the bed.</p>
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<p>If there was significant bleeding, especially if the woman was symptomatic, then that would change everything. If a woman was lightheaded or dizzy, baby would for sure get handed off to someone else. If a woman was feeling symptomatic of blood loss, I would also find myself in a bigger hurry to get her out of the pool than I normally am. Also, if the bed wasn't close and the woman had lost a good amount of blood then she may not get to her bed right away. I ask families to have a mattress close by the pool if they are setting it up far away from their own bedroom for cases like this. That way we can get the woman to a restful surface with minimal effort.</p>
 

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<p>We rarely cut the cord before the placenta. But if mom has a history of bleeding we usually get her out of the tub for the placenta. She holds the baby with someone supporting her . It is rarely a problem.</p>
 

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Discussion Starter #5
<p>Thank you for your replies.  Would still love to hear more.</p>
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<p>Complete, you said it is "rarely" a problem.  Do you mean it has never been a problem, or has it ever been a problem?  What kind of problem?</p>
 

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I usually do placenta in pool. Cut cord before or after placenta. Baby to daddy, daddy to bed. Me and birth assistant help mama out if pool, dry off, straight to bed, where dad us chillaxing. Perineum check, sometimes, then babe to mama arms.<br><br>
Lots of variations, tho.
 

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<p>We usually do placenta in the pool. Scoop it into a plastic bowl (so the bowl floats) and then when we are ready to move out of the pool and into bathroom/bed etc we place the placenta in a chucks pad and duct tape it shut, place it in a plastic grocery bag.  This is ultra easy because whoever has baby can place the grocery sack around there arm and carry baby and placenta.  Then there is no rush to cut the cord.</p>
 

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<p>I do both of the choices listed - depends on the mom's preference.  I don't generally do the placenta is the pool.  Some moms are fine with holding the baby while transferring back to the bed, some prefer to cut the cord before getting out and giving baby to a support person.  Usually we wait for the cord to stop pulsing, which seems to happen more slowly in the tub, so do end up with placenta in transit on occasion.  Like someone said, lots of variations, we just do what works for that birth.  I do deliveries in the hospital - the tub and bed are across the room from each other but b/c the bed is on wheels we just bring it nice and close to the tub when mom is ready to transfer.  She steps out of the tub, gets a quick towel dry, then right onto the bed with a warm blanket over her. </p>
 

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<p>One of the varied reasons I am torn about doing waterbirths - mainly there is an interruption in the natural behavior & bonding of mother and baby. Personally, as a midwife I want to see what is happening with the mom's bleeding and do not (in a darkened room and a deep pool of water) have the skill to see how much she might be bleeding. So out of the tub and to the bed, cord attached, she goes - wthin the first 15 minutes.</p>
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<p>Aside from that, the way babies are born in the water intereferes with a woman's natural birthing instincts, takes her out of her primal brain and generally, requires assitance from the midwife or someone else close by to retrieve baby and put him/her in her arms. Most mama's birth, giving birth uninhindered, do not automatically scoop baby into their arms - they need TIME to come back into thier bodies. Then they tentatively explore baby with their fingers, touching limbs and extremeities, then whole body....and when they scoop them up, they smell them. Babies born in the water have the smell of birth washed off them.</p>
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<p>Waterbirth, in my mind is not "normal"....it is nice, but not how we would normally give birth if no one were there. It is nice, and I will suppot women in doing so, but it is not "natural" and I really, really love land births for that reason....the less I have to do, the better.</p>
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<p>lesleymidwife</p>
 

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Discussion Starter #10
<p>I agree Lesley, I do a lot of waterbirths but I'm starting to steer women away from them a little bit, unless that's what they have their heart set on.  </p>
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<p>My question had less to do with the timing of cord cutting and more to do with who carries baby from tub to bed.  I am EXTREMELY uncomfortable with mom standing up, climbing out of the tub, and walking to the bed while holding her baby.  If I as a non-freshly-postpartum woman were holding a baby in a tub, I would not want to perform such a feat, even with "support."  However, I work with other midwives who do this regularly and see no problem with it.  I think if a mom told me she wanted to carry her baby like this, that would be one thing, but generally she is looking to me for guidance as to how to manage getting out of the tub and to the bed.  I think that the very brief amount of time that baby is out of mom's arms while she makes this short journey is acceptable compared to the risk of the baby slipping out of her arms, her accidentally squeezing baby too tight while she's shifting her weight to stand, fainting to the floor so I am required to try to catch her and her baby on the way down... I think there is a lot of potential for a disaster.  I wanted to hear how other midwives manage this.  The way I was trained, baby is always handed off (briefly, and usually to dad if he is present) while mom moves.  I don't know if I should just force myself to relax and not fret while I'm watching this process (mom carrying baby) or if I am right to be concerned.  </p>
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<p>As far as my own clients are concerned, I don't think I will ever advise the mom-carries method.  Again, if mom tells me this is what she wants, that's different.  But if she's expecting me to advise her on what's the best way to go, I just can't advise that she hold baby for that walk.  </p>
 

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<p>We have done an indepth estimated blood loss workshop here and feel very confident about two people estimating a hemmorhage.</p>
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<p>That being said, I do what the mom wants. If she is okay and the baby is okay and she wants to be in the tub, she can birth the placenta in the tub. Or she can get out. She can hand over the baby if needed, or hold on to the baby with a second set of hands supporting her hands. Either way works!</p>
 
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